In clinical studies, HEMGENIX was safe and effective, with no treatment-related serious adverse events and no development of factor IX inhibitors reported.
Alanine aminotransferase increased
24 (42%)
Headache
10 (18%)
Blood creatine kinase increased
24 (42%)
Flu-like symptoms
8 (14%)
Infusion-related reactions† (see below)
19† (33%)
Hypersensitivity
2‡ (4%)
Fatigue
7 (12%)
Aspartate aminotransferase increased
24 (42%)
Nausea
4 (7%)
Malaise
7 (12%)
*N=57 patients (N=3 patients from a Phase 2b and N=54 patients from a Phase 3 clinical study).
†Infusion-related reaction: In 7 subjects, symptoms occurred during infusion; in 12 subjects, after infusion.
Symptoms occurring in ≥5% of subjects were: Dizziness, flu-like symptoms and headache. Symptoms occurring in <5% of subjects were: Abdominal pain, abdominal discomfort, chest discomfort, chills, eye
pruritus, fever (pyrexia), flushing, hives (urticaria), infusion site reaction, and tachycardia. Eleven subjects recovered on the day or day after infusion. Eight subjects recovered within 8 days after infusion.
‡One of 2 hypersensitivity reactions: 12 minutes after initiation of administration of HEMGENIX, the patient experienced high blood pressure, red eyes, feeling warm, dizziness, coughing, dyspnea, elevated heart rate, shivering, and leg cramps. Infusion was stopped and not restarted. Only 10% of the dose of HEMGENIX was administered. The patient recovered on the same day after treatment with intravenous diphenhydramine and intramuscular epinephrine.
2 of 2 hypersensitivity reactions: 10 minutes after initiation of administration of HEMGENIX, the patient experienced itching, tightness of throat, and swelling of the right side of the neck. The dose of HEMGENIX was not interrupted and administered in full. All symptoms resolved on the same day without treatment.
See the steps to administering HEMGENIX
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Patient eligibilityWarning and Precautions
Infusion Reactions
Infusion reactions, including hypersensitivity reactions and anaphylaxis, may occur. Monitor during administration and for at least 3 hours after end of infusion. If symptoms occur, slow or interrupt administration. Re-start administration at a slower infusion once resolved.
Hepatotoxicity/Hepatocellular Carcinoma
Post-dose, monitor for elevated transaminase levels. Consider corticosteroid treatment should elevations occur. The integration of liver-targeting AAV vector DNA into the genome may carry the theoretical risk of hepatocellular carcinoma development. For patients with preexisting risk factors for hepatocellular carcinogenicity, perform regular (eg, annual) abdominal ultrasound and alpha-fetoprotein testing following administration.
Immune-mediated neutralization of the AAV5 vector capsid
Preexisting neutralizing anti-AAV antibodies may impede transgene expression at desired levels.
Monitoring Laboratory Tests
In addition to monitoring liver function, monitor for Factor IX activity and Factor IX inhibitors after administration.
Adverse Reactions
The most common adverse reactions (incidence ≥5%) were elevated ALT, headache, blood creatine kinase elevations, flu-like symptoms, infusion-related reactions, fatigue, nausea, malaise, and elevated AST.
Indication
HEMGENIX®, etranacogene dezaparvovec-drlb, is an adeno-associated virus vector-based gene therapy indicated for the treatment of adults with Hemophilia B (congenital Factor IX deficiency) who:
HEMGENIX is for single use intravenous infusion only.
Contraindications: None.
Please see full prescribing information for HEMGENIX.
To report SUSPECTED ADVERSE REACTIONS, contact the CSL Behring Pharmacovigilance Department at 1-866-915-6958 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.